REQUISITION & PROPOSAL

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1 DATE 10/24/ The Alabama State Port Authority requests pricing on the following or approved equal: Direct all technical inquiries to Scott McAfee or OR BO STRICKLAND OR PROPOSAL SPECIFICATION FOR NEW T650 COMPACT TRACK LOADER W/ LOADER RADIO REMOTE CONTROL SYSTEM OR EQUIVALENT COMPACT TRACK LOADER Vertical Lift Arm Path 2570 lbs. RATED OPERATING CAPACITY Must have a certified service dealer within 25 miles of ASPA. ASPA reserves the right to purchase additional compact track loaders for the next 12 months starting the day this bid is awarded if the vendor agrees to the same price. Bid Opening: 10/24/13 at 10 A.M. in the McDuffie Conference Room Bids Must be Labeled: COMPACT TRACK LOADER PURCHASE OF NEW COMPACT TRACK LOADER W/ LOADER RADIO REMOTE CONTROL SYSTEM Recommended: Dillon Sims, Associate Buyer Approved: Scott McAfee, Equipment Superintendent Scott Wallace, Maintenance Manager Brad Ojard, Vice President Operations H. S. Smitty Thorne, Deputy Director / COO Larry R. Downs, Sec. / Treasurer James K. Lyons, Director & CEO Page 1 of 22

2 10/24/13 Check YES or NO on each line for Pages DIMENSIONAL SPECIFICATIONS Angle of Departure 31 Dump Maximum Height 42 Dump Height with Standard Bucket 96.3" (2447 mm) Maximum Height 34.2" (870 mm) Ground Clearance 8.1" (207 mm) Height to Hinge Pin 124" (3149 mm) Cab Height 81.3" (2065 mm) Length without Attachment 108.4" (2753 mm) Length with Standard Bucket 136.8" (3474 mm) Overall Operating Height 158.5" (4026 mm) Carry Position 8.6" (218 mm) Rollback Carry Position 31 Turning Radius with Standard Bucket 87.7" (2228 mm) Length of Track on Ground 59" (1499 mm) Overall Width 12.6 Tracks 72.9" (1851 mm) Bucket Width 74" (1880 mm) Overall Width 17.7 Tracks 78" (1981 mm) Bucket Width 80" (2032 mm) Page 2 of 22

3 PERFORMANCE Rated Operating Capacity (per ISO ) Solid-Mounted Undercarriage Roller Suspension Undercarriage (Optional) 2570 lbs. (1166 kg) 2350 lbs. (1066 kg) Tipping Load (per ISO ) 7343 lbs. (3331 kg) 6714 lbs. (3045 kg) Operating Weight (SAE J732) 9440 lbs. (4282 kg) lbs. (4707 kg) Travel Speed 6.6 mph (10.6 km/hr) 6.6 mph (10.6 km/hr) Lift Breakout Force 6400 lbs. (2903 kg) 6800 lbs. (3048 kg) Tilt Breakout Force 5500 lbs. (2495 kg) 5800 lbs. (2631 kg) Push Force 6400 lbs. (2903 kg) 7280 lbs. (5486 kg) Ground Pressure with 12.6 Tracks Ground Pressure with 17.7 Track 5.8 psi (0.04 MPa) 6.3 psi (0.044 MPa) 4.4 psi (0.03 MPa) 4.6 psi (0.032 MPa) Page 3 of 22

4 ENGINE/ELECTRICAL Loader shall have a 4 cylinder, liquid-cooled diesel; 74.3 hp (55.4 kw) at 2400 governed RPM. Loader engine shall a have minimum torque of 195 lbf-ft (264.4 N-m) at 1600 RPM. Loader engine shall be turbo charged. Loader shall be equipped with a hydraulically driven, variable speed cooling fan. Engine must meet EPA Interim Tier IV Emission Standards. Spark arrestor muffler, dual element air cleaner and glow plug cold weather assist shall be provided as standard equipment. Cold weather assist shall be automatically activated. Air cleaner shall be a dry replaceable cartridge with safety element. Engine coolant shall include propylene glycol anti-freeze with freeze protection to - 34ºF (-37ºC). Loader shall be equipped with a dual path cooling system which brings cool, clean air from above the machine for engine and hydraulic system cooling. While at the same time removing hot air from the engine and hydrostatic area. Battery shall be a 12 volt with a minimum of 950 cold-cranking amps. Alternator shall be a minimum 90 amp. Starter shall be a 12 volt; 4.02 hp (3.0 kw), gear type. Engine accessory belt shall not require any adjustments. Engine shutdown shall be provided as standard equipment and shall monitor engine coolant temperature, engine oil pressure and engine RPM to help prevent engine damage. Engine block heater shall be provided as optional equipment to provide easier starting during cold weather operation. Catalytic exhaust purifier shall be provided as optional equipment. Air intake pre-cleaner shall be provided as optional equipment. Page 4 of 22

5 DRIVE SYSTEM Shall have a fully hydrostatic track drive. Transmission shall be infinitely variable tandem hydrostatic piston pumps, driving two fully reversing hydrostatic motors. Hydrostatic piston pumps shall be belt driven from the engine. Drive belt shall not require any adjustments. Shall have a roller type suspension. Shall have 4 suspended rollers per side. Shall have an all steel suspension design. Steel rollers and idlers shall be permanently sealed and lubricated requiring no routine maintenance. Shall use austempered ductile iron sprockets. Grease cylinder shall be used for adjustment. Track tension shall be adjusted by adding grease to the tensioning cylinder. Rubber track shall have steel cables and embeds. Parking brake shall be spring applied, pressure release multi-disk brake. Tracks: 17.7 rubber tracks Page 5 of 22

6 HYDRAULIC SYSTEM - Pump type shall be a gear type pump for standard flow hydraulics. - Hydraulic pump capacity for standard flow shall be capable of providing 23 gpm (87.1 L/min) for bucket, lift arm and attachment operation. - System pressure at the quick couplers shall be 3500 psi (24.2 MPa). - Variable flow auxiliary hydraulics shall be standard equipment. - Shall include flush-face pressure release quick couplers. - Shall include dual direction detent. - Control valve shall be three spool, open center, series type. - Lift spool shall include a detent position for lift arm float function. - Front auxiliary hydraulic spool shall include a detent function in both forward and reverse directions. - Cylinders shall be a double-acting type. Dual tilt cylinders shall have a cushioning feature on dump and roll back. - Hydraulic system shutdown shall be provided as standard equipment and shall monitor hydraulic oil temperature and hydrostatic charge pressure. - A hydraulic oil cooler shall be standard equipment. - Auxiliary hydraulic hoses shall be routed inside the lift arm. - Shall have inertia welded rods and bases at the end of the cylinders. - Shall have rear auxiliary hydraulics as an option and include. - Electric finger controls on left joystick. - Lift circuit port relief valve shall be standard equipment. - Auxiliary hydraulics circuit port relief valve shall be available as an option. - A feature for draining pressure from the auxiliary hydraulics circuit shall be provided by pressing and holding the quick couplers. Cylinders shall meet the following minimum specifications: Function # of Cylinders Bore Diameter Rod Diameter Stroke Y N Lift " (76.2 mm) 1.75" (44.5 mm) 24.93" (633.2 mm) Y N Tilt " (76.2 mm) 1.63" (41.4 mm) 13.97" (354.8 mm) Page 6 of 22

7 OPERATOR CONTROLS - Loader direction, steering, and travel speed shall be controlled by two independent steering levers. - Loader lift and tilt functions. - Shall be selectable between foot pedals or hand lever controls. - Optional Selectable Joystick Control (SJC) system shall be available to allow operator to switch between ISO control pattern (loader direction, steering and travel speed on left hand joystick; loader lift and tilt functions on right hand joystick) or H- Pattern (left hand joystick controls lift function and left side drive function; right hand joystick controls tilt function and right side drive function). - Speed Management shall be available on SJC equipped loaders to allow the loader to be maneuvered at a slower travel speed, even during maximum movement of the joysticks. - Drive Response shall be available on SJC equipped loaders to change how responsive the loader s drive and steering systems are when the operator moves the joysticks. - Steering Drift Compensation shall be available on SJC equipped loaders to be used to reduce steering drift to maintain a desired travel path in both forward and reverse directions. - Horsepower Management shall be available on SJC equipped loaders to allow the engine to operate at maximum horsepower and torque. - Standard front auxiliary hydraulics shall be controlled by electrical switches located on the right steering lever handle or right hand joystick. - Engine speed shall be controlled by a hand lever mounted on right hand cab post. - Engine speed shall be controlled by a foot pedal with optional Selectable Joystick Controls. - Parking brake shall be controlled by a finger operated rocker switch on left hand cab post. - Engine starting and shutdown functions shall be controlled electrically with a key switch or optional keyless start. Page 7 of 22

8 OPERATOR COMFORT A suspension seat shall be standard equipment. Arm rest shall be standard equipment. Cup holder kit shall be available as an option. Engine throttle shall be located directly in front of the operator. The optional Selectable Joystick Control system shall be mounted to the seat and shall be able to adjust independently of the seat. Top and rear windows shall be available as standard equipment. Shall have special application polycarbonate doors and windows available as an option. Front and rear operating lights shall be available as standard equipment. Clean out holes in the foot well shall be provided as standard equipment. CAPACITIES Fuel Tank shall have a minimum capacity of 27.3 gal. (103.3 L). Cooling System without heater shall have a minimum capacity of 3.0 gal. (11.4 L). Hydraulic Reservoir shall have a minimum capacity of 2.7 gal. (10.2 L). Hydrostatic System shall have a minimum capacity of 11.0 gal. (45 L). Page 8 of 22

9 STANDARD LOADER INSTRUMENTATION Gauges Engine Coolant Temp Fuel Level The loader conditions shall be monitored by a combination of gauges and warning lights in the operator's line of sight that monitor the following functions. The system shall alert the operator of monitored loader malfunctions by way of an audible alarm and visual warning lights. Warning Lights Engine Coolant Temp Engine Malfunction Fuel Level General Warning Hydraulic Malfunction Indicators Seat Bar Lift & Tilt Valve Parking Brake 2-Speed Seat Belt 3-Point Shoulder Belt Turn Signals Data Display Screen Battery Voltage Drive Response Setting Engine Preheat Engine RPM Maintenance Clock Hour Meter Service Codes Speed Management Steering Drift Page 9 of 22

10 DELUXE LOADER INSTRUMENTATION The following features of the Deluxe Instrument Panel with Keyless Start are in addition to the Standard Instrument Panel: Additional Displays for: Coolant Temperature & Oil Pressure Engine RPM Hydraulic Oil Temperature Hydrostatic Charge Pressure System Voltage Keyless Start Multi-Language Display Password Lockout High Flow Lockout 2-Speed Lockout Attachment Control Additional Features: Diagnostic Capability Digital Clock Engine/Hydraulic Systems Shutdown Function Help Screens Job Clock ATTACHMENTS - All attachments shall be mounted on a quick-change mechanism. No attachments will be considered unless it can be removed or mounted by an experienced operator in two minutes or less. - The quick change mechanism will incorporate two handles that drive spring loaded, wear compensating wedges into the attachment ensuring a tight attachment fit-up. - The quick change mechanism shall be driven by hydraulics and be available as an option. - Backhoe operation shall be possible with the lift arms in the down position. - A remote attachment control device shall be available for specified attachments to start the loader and operate the attachment from outside the operator control area. - A single control unit shall be provided which will control all available attachments. - Standard flow hydraulics shall be available as standard equipment. Page 10 of 22

11 SERVICEABILITY SAFETY EQUIPMENT - Access shall be available to the following through the rear door/tailgate and rear screen. Air cleaner Alternator Battery Cooling system (engine oil and hydraulic oil coolers) for cleaning Engine oil and fuel filters Engine oil drain and dipstick Starter - Easy access shall be available to all lift arm grease points. - Quick-Tach pivots shall have replaceable wear bushings. - Rod end of the tilt cylinder shall have a replaceable bushing. - Tailgate shall have an optional lock for vandal proofing. - Tailgate shall be equipped with doorstop to hold door open while servicing. - Tip-up operator cab shall give access to certain hydraulic system components. - An enclosable operator cab with side screens shall be provided as standard equipment. Cab shall meet SAE standards J1040 and J1043 for Rollover Protective Structure and Falling Object Protective Structure. Minimum inside cab width of 33" (838 mm). - A seat belt and an electric switch operated parking brake shall be furnished as standard equipment. - Additional operator protection shall be provided by a seat bar or similar device which restricts lift arm operation when not in use. - A lift arm support device shall assist in servicing the loader and be provided as standard equipment. - Grab handles shall assist the operator in mounting and dismounting the loader will be provided as standard equipment. - Loader shall be equipped with an interlock control system which requires that the operator be seated in the loader with the seat bar down in place and the engine running before the hydraulic lift, tilt and the traction drive system can be operated. The auxiliary hydraulics shall deactivate when the operator raises the seat bar. Should the engine not start or a system problem occur with the lift arms raised, the lift arms can be lowered by turning the lift arm bypass control knob clockwise ¼ turn. Then, pull up and hold until the lift arms slowly lower. - Shall have operational instructions and warnings by decals with pictorials and international symbols plus some messages in four basic languages: English, French, German and Spanish. - Shall have a weather resistant operator handbook written in English attached to the loader. - Loader shall include an alarm package including a horn and backup alarm. - Fire extinguisher shall be available as an option. Page 11 of 22

12 TRAINING RESOURCES - A comprehensive Compact Track Loader Operator Training Kit shall be available. The kit shall include a video, classroom and hands-on training. This kit shall also be available in Spanish. - A comprehensive Service Safety Training Kit shall be available. The kit shall include a video, classroom and hands-on training. LOADER RADIO REMOTE CONTROL SYSTEM Specifications Loader Radio Remote Control System Operator Training Course available Operation, Maintenance & Parts Manual tethered to transmitter Start engine and operate the drive, lift, tilt and auxiliary hydraulic functions of the loader using the Radio Remote Control Transmitter Easily installs and is transferable between approved Bobcat skid-steer loaders or compact track loaders equipped with Selectable Joystick Controls (SJC) and Bobcat All-Wheel Steer (AWS) loaders Easily switch between REMOTE control mode and MACHINE / DIRECT control mode Transmitter joystick controls operate similar to loader joystick controls in the ISO control pattern Designed to work in various climate conditions Rechargeable battery with up to 15 hour battery life Transmitting Range Wireless operating range is approximately 1500 feet (500 meters). Visual contact with the loader and its travel path is required. Transmitting range will vary depending upon work site conditions. Transmitter/Receiver Configuration The transmitter and receiver configuration is factory set and must be used as a matched pairs. (See I.D. Tags on transmitter and receiver for numbers.) Transmitter Weight 8.5 lbs. (Without straps) Operating Frequency License Free 2.4 GHz per FCC PART 18 (with Interference Free Frequency Hopping Spread Spectrum.) Transmitter Tilt Sensor Transmitter stops loader engine if transmitter is tilted over 45 degrees in any direction, and is equipped with a guard bar to prevent accidental activation of controls. Battery Specifications 9.6 Volt DC battery, up to 15 hour battery life per charge 12 Volt DC input auto battery charger Page 12 of 22

13 NEW T650 COMPACT TRACK LOADER W/ LOADER RADIO REMOTE CONTROL SYSTEM OR EQUIVALENT MAKE MODEL YEAR Price DOES THE MACHINE HAVE A LOADER RADIO REMOTE CONTROL SYSTEM $ YES NO Is there a certified service dealer within 25 miles? YES NO Do your service technicians already have ASPA credentials? How long is the warranty? DELIVERY TIME ARO WEEKS Your Price Must Include Free Delivery YES NO MONTHS Page 13 of 22

14 TO: Prospective Bidders Bid opening will be October 24, 2013 at 10:00 a.m. in the McDuffie Island Conference Room. NO BIDS WILL BE ACCEPTED AFTER THIS TIME. PLEASE SEE ATTACHED INDEMNIFICATION SHEET & DISCLOSURE STATEMENT Company Address Representative Phone Number FOR ALL PROPOSALS $7,500 AND OVER STATE OF ) COUNTY OF ) On this day of, 20, before me appeared, to me personally known, who, being by me duly sworn, did say that such person executed the foregoing instrument as the free act and deed of such person, having been duly authorized to execute such instrument in such capacity. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public, State of Print Name My commission expires: Page 14 of 22

15 Alabama State Docks/Port Authority Bid Description: Purchase new T650 Compact Track Loader w/radio Remote Bids to be Open: 10/24/13 The following paragraph shall be considered a part of the above referenced bid: Indemnification Clause The Contractor shall assume all liability for and shall indemnify and save harmless the State of Alabama and the Alabama State Docks/Port Authority and its officers and employees from all damages and liability for injury to any person or persons, and injury to or destruction of property, including the loss of use thereof, by reason of an accident or occurrence arising from operations under the contract, whether such operations are performed by himself or by any subcontractor or by anyone directly or indirectly employed by either of them occurring on or about the premises, or the ways and means adjacent during the term of the contract, or any extension thereof, and shall also assume the liability for injury and/or damages to adjacent or neighboring property by reason of work done under the contract. Page 15 of 22

16 Please use this as a guide only for proper delivery. Sender Name & Address Alabama State Port Authority McDuffie Coal Terminal Postal Address for US Mail Physical Address for Courier Service Sealed Proposal: (Description) Proposal Opening Date: Page 16 of 22

17 Please return one copy of this proposal, duly signed, by 10 o clock a.m. October 24, When all proposals are publicly opened, UNIT PRICES AND EXTENSIONS shall be entered opposite each item above on which you are prepared to bid for delivery FREE OF CHARGE TO - McDuffie Coal Terminal (FOB) ALABAMA STATE DOCKS No consideration will be given proposals unless on this form or a written attachment. If not prepared to submit a proposal, please state over the firm signature and return so that it may be known it was brought to your attention; otherwise your name may be dropped form the list of prospective vendors. The right is reserved to reject any an all proposals deemed for the interest of the Alabama State Port Authority, to strike out any item or items in the proposals, and to waive any defect or irregularly not a violation of law or to make any modification in the several conditions herein stipulated that are deemed to be in the best interest of the Alabama State Port Authority, including the separation of items of a class in making awards. In general, awards will be made to the lowest satisfactory vendor. No Allowance will be made for errors, either of omission or commission, on the part of the vendors. It must be assumed that vendors have fully informed themselves as to all conditions, requirements, and specifications before submitting proposals and they can not expect to be excused or relieved from the responsibility assumed by their proposals on the plea of error. In case of error in extension of prices the unit price will govern. The Port Authority reserves the right to refuse to issue a proposal form or a contract to a prospective vendor for any of the following reasons: a) Failure to pay, or satisfactorily settle, all bills due for labor and materials on a former contract in force with the Port Authority. b) Contractor default under a previous Contract with the Port Authority. c) Proposal withdrawal or Bid Bond forfeiture on a previous project with the Port Authority. d) Unsatisfactory work on a previous contract with the Port Authority. Port Authority may make such investigations as deemed necessary to determine the ability of the vendor to perform the work, and the vendor shall furnish all such information and data for this purpose as the Port Authority may request. The Port Authority reserves the right to reject any proposal if the evidence submitted by, or investigation of, such vendor fails to satisfy the Port Authority that such vendor is properly qualified to carry out the obligations of the Contract. Page 17 of 22

18 FORM FOR SECTIONS 9(a) and (b) BEASON-HAMMON ALABAMA TAXPAYER AND CITIZEN PROTECTION ACT; CODE OF ALABAMA, SECTIONS (a) and (b) AFFIDAVIT FOR BUSINESS ENTITY/EMPLOYER/CONTRACTOR (To be completed as a condition for the award of any contract, grant, or incentive by the State of Alabama, and political subdivision thereof, or any state-funded entity to a business entity or employer that employs one or more employees) State of County of Before me, a notary public, personally appeared (print name) who, being duly sworn, says as follows: As a condition for the award of any contract, grant, or incentive by the State of Alabama, any political subdivision thereof, or any state-funded entity to a business entity or employer that employs one or more employees, I hereby attest that in my capacity as (state position) for (state business entity/employer/contractor name) That said business entity/employer/contractor shall not knowingly employ, hire for employment, or continue to employ an unauthorized alien. I further attest that said business entity/employer/contractor is enrolled in the E-Verify program. (ATTACH DOCUMENTATION ESTABLISHING THAT BUSINESS ENTITY/EMPLOYER/CONTRACTOR IS ENROLLED IN THE E-VERIFY PROGRAM) Signature of Affiant Sworn to and subscribed before me this day of, 2. I certify that the affiant is known (or made known) to me to be the identical party he or she claims to be. Signature and Seal of Notary Public Author: Jean Brown Statutory Authority: Code of Alabama, sections (a) and (b); Section (h). Page 18 of 22

19 All construction vehicles, employees, and supplier delivery trucks working on this project will be required to obtain port access credentials. This will consist of vehicle decals and personnel identification badges (Transportation Worker Identification Credentials and ASPA Identification Badge). Supplier delivery trucks are not required to have the vehicle decal but the driver and passengers are required to have TWIC and the ASPA Identification Badge. The vehicle decal cost is $ In order to obtain the ASPA Identification Badge, the person must have in possession a TWIC card and will also be required to attend a 1-hour security awareness training class. The non-refundable fee for ASPA Identification badge is $25.00 to cover the costs of the background check, training, and processing. The procedure and cost for obtaining TWIC are separate and information can be obtained at A copy of the ASPA Access Policy is herein and is part of contract specifications. ACCESS POLICY IMPORTANT NOTICE TO VENDORS REGARDING ACCESS TO ASPA RESTRICTED FACILITIES: Successful vendors requiring access to the Alabama State Port Authority's Restricted Facilities to fulfill any obligations set forth in this proposal must comply fully with the Authority's Access Policy found in its entirety at The Port Authority's Access Policy requires all persons permanently employed at the port, including ASPA staff, tenants and their employees, surveyors, agents, stevedores, longshoremen, chaplains, contract labor and persons requesting temporary access to the port, including delivery persons, vendors, contractors, and temporary workers must obtain and display an ASPA issued photo ID badge or visitor badge at all times when accessing or working on port property. In order to obtain an ASPA credential, applicants must also obtain a Transportation Worker Identification Credential (TWIC) and undergo mandatory Security Awareness Training. Information on the TWIC can be found at Information on Security Awareness Training classes and scheduling can be found at ALL PROSPECTIVE VENDORS ARE ENCOURAGED TO REVIEW THESE POLICIES AND CONSIDER THESE REQUIREMENTS IN PREPARING PROPOSAL SUBMISSIONS. Page 19 of 22

20 INSTRUCTIONS FOR VENDORS This instruction sheet is provided as a guide to facilitate the proposal process and highlight important points for consideration by vendors. Each vendor is responsible for fully reading and complying with the instructions on the Alabama State Port Authority proposal form. This instruction sheet is to be used as a guide only. 1. No consideration will be given to proposals unless presented on the Alabama State Port Authority "Requisition & Proposal" Form with suitable attachments as deemed necessary by the vendor. Alternate proposals may be rendered, with proper support. 2. If your company is not prepared to submit a proposal, so state and sign to avoid being deleted from the prospective vendor's list. 3. The Alabama State Port Authority reserves the right to reject any and all proposals if deemed in the Alabama State Port Authorities' interest. 4. No allowance will be made for error, either omission or commission. 5. Unit price governs in errors relating to extension of prices. 6. Proposals will not be accepted via FAX. All proposals must be sealed and sent via mail or hand delivered to the McDuffie Coal Terminal Office before the specified date and time. 7. The Alabama State Port Authority accepts no responsibility for facilitating the receipt of proposals. 8. Proposals over $7,500 must be notarized. 9. Proposals received after specified opening time will be returned to the vendor unopened. Vendors are requested to show a return address on the proposal envelope. 10. Proposals must be filled out completely, including the name, address, telephone number, fax number (if possible) and signature of responsible person. 11. Questions may be directed to the Alabama State Port Authority McDuffie Coal Terminal, Dillon Sims, at (251) All hand delivered proposals must be tendered to Alabama State Port Authority, McDuffie Coal Terminal Office 1901 Ezra Trice Blvd., Mobile AL 36603, at or before specified time. 13. All regular U.S. Postal Mail must be tendered to: Alabama State Port Authority ATTN: Dillon Sims McDuffie Coal Terminal P.O. Box 1588 Mobile, AL All courier / overnight deliveries (UPS, FEDEX, DHL, etc.) must be delivered to: Alabama State Port Authority McDuffie Coal Terminal ATTN: Dillon Sims 1901 Ezra Trice Blvd. Mobile, AL Note: all overnight proposals must be FIRST PRIORTY OVERNIGHT. (8:30 A.M. NEXT MORNING) 16. Notarization not required on "SALE" proposals. 17. Please specify the purchase order number (when available) on envelope. Page 20 of 22

21 Page 21 of 22

22 THIS PAGE MUST BE NOTARIZED Page 22 of 22

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